End effector joystick for a positioning device

ABSTRACT

A medical navigation system is provided having a positioning device having a positioning arm with a flange at the end of the positioning arm, a controller at least electrically coupled to the positioning device, and an end effector joystick controller for connecting to the flange of the positioning arm. The controller has a processor coupled to a memory and a display. The end effector joystick controller includes a mating component for connecting to the flange of the positioning arm, and a joystick portion extending from the mating component.

TECHNICAL FIELD

The present disclosure is generally related to image guided medicalprocedures, and more specifically to an end effector joystick for amedical procedure positioning device employing a dynamic positioningsystem.

BACKGROUND

The present disclosure is generally related to image guided medicalprocedures using a surgical instrument, such as an optical scope, anoptical coherence tomography (OCT) probe, a micro ultrasound transducer,an electronic sensor or stimulator, or an access port based surgery.

In the example of a port-based surgery, a surgeon or robotic surgicalsystem may perform a surgical procedure involving tumor resection inwhich the residual tumor remaining after is minimized, while alsominimizing the trauma to the intact white and grey matter of the brain.In such procedures, trauma may occur, for example, due to contact withthe access port, stress to the brain matter, unintentional impact withsurgical devices, and/or accidental resection of healthy tissue. A keyto minimizing trauma is ensuring that the surgeon performing theprocedure has the best possible view of the surgical site of interestwithout having to spend excessive amounts of time and concentrationrepositioning tools and cameras during the medical procedure. A keyaspect of this is having proper control of the tools used during themedical procedure.

FIG. 1 illustrates the insertion of an access port into a human brain,for providing access to internal brain tissue during a medicalprocedure. In FIG. 1, access port 12 is inserted into a human brain 10,providing access to internal brain tissue. Access port 12 may includesuch instruments as catheters, surgical probes, or cylindrical portssuch as the NICO BrainPath. Surgical tools and instruments may then beinserted within the lumen of the access port in order to performsurgical, diagnostic or therapeutic procedures, such as resecting tumorsas necessary. The present disclosure applies equally well to catheters,DBS needles, a biopsy procedure, and also to biopsies and/or cathetersin other medical procedures performed on other parts of the body.

In the example of a port-based surgery, a straight or linear access port12 is typically guided down a sulci path of the brain. Surgicalinstruments would then be inserted down the access port 12.

Optical tracking systems, used in the medical procedure, track theposition of a part of the instrument that is within line-of-site of theoptical tracking camera. These optical tracking systems also require areference to the patient to know where the instrument is relative to thetarget (e.g., a tumor) of the medical procedure. These optical trackingsystems require a knowledge of the dimensions of the instrument beingtracked so that, for example, the optical tracking system knows theposition in space of a tip of a medical instrument relative to thetracking markers being tracked. This enables a camera system thatfocuses on the surgical site of interest to display an image of thesurgical site on a monitor so that the surgeon can see the surgical siteat the end of the access port.

Conventional systems have not offered good solutions for manuallycontrolling positioning of a medical procedure positioning device.Presently, it is difficult to manually move an end effector of a medicalpositioning device because at times it requires a surgeon to positionhimself in a non-optimal ergonomic position and/or use an excessive orawkward amount of force to manually position the end effector. It wouldbe desirable to have an end effector and medical positioning device thatsatisfies the needs of operating room in the context of the proceduresmentioned above.

SUMMARY

One aspect of the present disclosure provides a medical navigationsystem having a positioning device having a positioning arm with aflange at the end of the positioning arm, a controller electricallycoupled to the positioning device, and an end effector joystickcontroller for connecting to the flange of the positioning arm. Thecontroller has a processor coupled to a memory and a display. The endeffector joystick controller includes a mating component for connectingto the flange of the positioning arm and a joystick portion extendingfrom the mating component.

Another aspect of the present disclosure provides an end effectorjoystick controller for connecting to and controlling a positioning armof a positioning device of a medical navigation system. The end effectorjoystick controller comprises a mating component for connecting to aflange of the positioning arm and a joystick portion extending from themating component. The joystick portion may further have a handle, and ahousing portion attached to the handle and the mating component. Thehandle may be in the shape of a puck.

A further understanding of the functional and advantageous aspects ofthe disclosure can be realized by reference to the following detaileddescription and drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments will now be described, by way of example only, withreference to the drawings, in which:

FIG. 1 illustrates the insertion of an access port into a human brain,for providing access to internal brain tissue during a medicalprocedure;

FIG. 2 shows an exemplary navigation system to support minimallyinvasive access port-based surgery;

FIG. 3 is a block diagram illustrating a control and processing systemthat may be used in the navigation system shown in FIG. 2;

FIG. 4A is a flow chart illustrating a method involved in a surgicalprocedure using the navigation system of FIG. 2;

FIG. 4B is a flow chart illustrating a method of registering a patientfor a surgical procedure as outlined in FIG. 4A;

FIG. 5 is an exemplary navigation system similar to FIG. 2 illustratingsystem components of an exemplary surgical system used in port basedsurgery;

FIG. 6 is perspective drawing illustrating a conventional end effectorholding a camera;

FIG. 7 is a perspective drawing illustrating another end effectorsimilar to that of FIG. 6;

FIG. 8 is a perspective drawing showing an end effector joystickcontroller coupled to an arm of a positioning device;

FIG. 9 is a side view of the end effector joystick controller of FIG. 8;

FIG. 10 is a perspective view of an end effector joystick controller inisolation;

FIG. 11 is an exploded view of the end effector joystick controller ofFIG. 10;

FIG. 12 is a perspective view of the end effector joystick controller ofFIG. 10 with a scope and camera attached;

FIG. 13 is an exploded view of the end effector joystick controller withattached scope and camera shown in FIG. 12;

FIG. 14 shows another embodiment of an end effector joystick controllerwith a scope and camera attached; and

FIG. 15 is an exploded view of the end effector joystick controller withattached scope and camera shown in FIG. 14.

DETAILED DESCRIPTION

Various embodiments and aspects of the disclosure will be described withreference to details discussed below. The following description anddrawings are illustrative of the disclosure and are not to be construedas limiting the disclosure. Numerous specific details are described toprovide a thorough understanding of various embodiments of the presentdisclosure. However, in certain instances, well-known or conventionaldetails are not described in order to provide a concise discussion ofembodiments of the present disclosure.

As used herein, the terms, “comprises” and “comprising” are to beconstrued as being inclusive and open ended, and not exclusive.Specifically, when used in the specification and claims, the terms,“comprises” and “comprising” and variations thereof mean the specifiedfeatures, steps or components are included. These terms are not to beinterpreted to exclude the presence of other features, steps orcomponents.

As used herein, the term “exemplary” means “serving as an example,instance, or illustration,” and should not be construed as preferred oradvantageous over other configurations disclosed herein.

As used herein, the terms “about”, “approximately”, and “substantially”are meant to cover variations that may exist in the upper and lowerlimits of the ranges of values, such as variations in properties,parameters, and dimensions. In one non-limiting example, the terms“about”, “approximately”, and “substantially” mean plus or minus 10percent or less.

Unless defined otherwise, all technical and scientific terms used hereinare intended to have the same meaning as commonly understood by one ofordinary skill in the art. Unless otherwise indicated, such as throughcontext, as used herein, the following terms are intended to have thefollowing meanings:

As used herein, the phrase “access port” refers to a cannula, conduit,sheath, port, tube, or other structure that is insertable into asubject, in order to provide access to internal tissue, organs, or otherbiological substances. In some embodiments, an access port may directlyexpose internal tissue, for example, via an opening or aperture at adistal end thereof, and/or via an opening or aperture at an intermediatelocation along a length thereof. In other embodiments, an access portmay provide indirect access, via one or more surfaces that aretransparent, or partially transparent, to one or more forms of energy orradiation, such as, but not limited to, electromagnetic waves andacoustic waves.

As used herein the phrase “intraoperative” refers to an action, process,method, event or step that occurs or is carried out during at least aportion of a medical procedure. Intraoperative, as defined herein, isnot limited to surgical procedures, and may refer to other types ofmedical procedures, such as diagnostic and therapeutic procedures.

Embodiments of the present disclosure provide imaging devices that areinsertable into a subject or patient for imaging internal tissues, andmethods of use thereof. Some embodiments of the present disclosurerelate to minimally invasive medical procedures that are performed viaan access port, whereby surgery, diagnostic imaging, therapy, or othermedical procedures (e.g., minimally invasive medical procedures) areperformed based on access to internal tissue through the access port.

Referring to FIG. 2, an exemplary navigation system environment 200 isshown, which may be used to support navigated image-guided surgery. Asshown in FIG. 2, surgeon 201 conducts a surgery on a patient 202 in anoperating room (OR) environment. A medical navigation system 205comprising an equipment tower, tracking system, displays and trackedinstruments assist the surgeon 201 during his procedure. An operator 203is also present to operate, control and provide assistance for themedical navigation system 205.

Referring to FIG. 3, a block diagram is shown illustrating a control andprocessing system 300 that may be used in the medical navigation system200 shown in FIG. 3 (e.g., as part of the equipment tower). As shown inFIG. 3, in one example, control and processing system 300 may includeone or more processors 302, a memory 304, a system bus 306, one or moreinput/output interfaces 308, a communications interface 310, and storagedevice 312. Control and processing system 300 may be interfaced withother external devices, such as tracking system 321, data storage 342,and external user input and output devices 344, which may include, forexample, one or more of a display, keyboard, mouse, sensors attached tomedical equipment, foot pedal, and microphone and speaker. Data storage342 may be any suitable data storage device, such as a local or remotecomputing device (e.g. a computer, hard drive, digital media device, orserver) having a database stored thereon. In the example shown in FIG.3, data storage device 342 includes identification data 350 foridentifying one or more medical instruments 360 and configuration data352 that associates customized configuration parameters with one or moremedical instruments 360. Data storage device 342 may also includepreoperative image data 354 and/or medical procedure planning data 356.Although data storage device 342 is shown as a single device in FIG. 3,it will be understood that in other embodiments, data storage device 342may be provided as multiple storage devices.

Medical instruments 360 are identifiable by control and processing unit300. Medical instruments 360 may be connected to and controlled bycontrol and processing unit 300, or medical instruments 360 may beoperated or otherwise employed independent of control and processingunit 300. Tracking system 321 may be employed to track one or more ofmedical instruments 360 and spatially register the one or more trackedmedical instruments to an intraoperative reference frame. For example,medical instruments 360 may include tracking markers such as trackingspheres that may be recognizable by a tracking camera 307. In oneexample, the tracking camera 307 may be an infrared (IR) trackingcamera. In another example, as sheath placed over a medical instrument360 may be connected to and controlled by control and processing unit300.

Control and processing unit 300 may also interface with a number ofconfigurable devices, and may intraoperatively reconfigure one or moreof such devices based on configuration parameters obtained fromconfiguration data 352. Examples of devices 320, as shown in FIG. 3,include one or more external imaging devices 322, one or moreillumination devices 324, a robotic arm 305, one or more projectiondevices 328, and one or more displays 311.

Exemplary aspects of the disclosure can be implemented via processor(s)302 and/or memory 304. For example, the functionalities described hereincan be partially implemented via hardware logic in processor 302 andpartially using the instructions stored in memory 304, as one or moreprocessing modules or engines 370. Example processing modules include,but are not limited to, user interface engine 372, tracking module 374,motor controller 376, image processing engine 378, image registrationengine 380, procedure planning engine 382, navigation engine 384, andcontext analysis module 386. While the example processing modules areshown separately in FIG. 3, in one example the processing modules 370may be stored in the memory 304 and the processing modules may becollectively referred to as processing modules 370.

It is to be understood that the system is not intended to be limited tothe components shown in FIG. 3. One or more components of the controland processing system 300 may be provided as an external component ordevice. In one example, navigation module 384 may be provided as anexternal navigation system that is integrated with control andprocessing system 300.

Some embodiments may be implemented using processor 302 withoutadditional instructions stored in memory 304. Some embodiments may beimplemented using the instructions stored in memory 304 for execution byone or more general purpose microprocessors. Thus, the disclosure is notlimited to a specific configuration of hardware and/or software.

While some embodiments can be implemented in fully functioning computersand computer systems, various embodiments are capable of beingdistributed as a computing product in a variety of forms and are capableof being applied regardless of the particular type of machine orcomputer readable media used to actually effect the distribution.

At least some aspects disclosed can be embodied, at least in part, insoftware. That is, the techniques may be carried out in a computersystem or other data processing system in response to its processor,such as a microprocessor, executing sequences of instructions containedin a memory, such as ROM, volatile RAM, non-volatile memory, cache or aremote storage device.

A computer readable storage medium can be used to store software anddata which, when executed by a data processing system, causes the systemto perform various methods. The executable software and data may bestored in various places including for example ROM, volatile RAM,nonvolatile memory and/or cache. Portions of this software and/or datamay be stored in any one of these storage devices.

Examples of computer-readable storage media include, but are not limitedto, recordable and non-recordable type media such as volatile andnon-volatile memory devices, read only memory (ROM), random accessmemory (RAM), flash memory devices, floppy and other removable disks,magnetic disk storage media, optical storage media (e.g., compact discs(CDs), digital versatile disks (DVDs), etc.), among others. Theinstructions may be embodied in digital and analog communication linksfor electrical, optical, acoustical or other forms of propagatedsignals, such as carrier waves, infrared signals, digital signals, andthe like. The storage medium may be the internet cloud, or a computerreadable storage medium such as a disc.

At least some of the methods described herein are capable of beingdistributed in a computer program product comprising a computer readablemedium that bears computer usable instructions for execution by one ormore processors, to perform aspects of the methods described. The mediummay be provided in various forms such as, but not limited to, one ormore diskettes, compact disks, tapes, chips, USB keys, external harddrives, wire-line transmissions, satellite transmissions, internettransmissions or downloads, magnetic and electronic storage media,digital and analog signals, and the like. The computer useableinstructions may also be in various forms, including compiled andnon-compiled code.

According to one aspect of the present application, one purpose of thenavigation system 205, which may include control and processing unit300, is to provide tools to the neurosurgeon that will lead to the mostinformed, least damaging neurosurgical operations. In addition toremoval of brain tumours and intracranial hemorrhages (ICH), thenavigation system 205 can also be applied to a brain biopsy, afunctional/deep-brain stimulation, a catheter/shunt placement procedure,open craniotomies, endonasal/skull-based/ENT, spine procedures, andother parts of the body such as breast biopsies, liver biopsies, etc.While several examples have been provided, aspects of the presentdisclosure may be applied to any suitable medical procedure.

Referring to FIG. 4A, a flow chart is shown illustrating a method 400 ofperforming a port-based surgical procedure using a navigation system,such as the medical navigation system 205 described in relation to FIG.2. At a first block 402, the port-based surgical plan is imported.

Once the plan has been imported into the navigation system at the block402, the patient is affixed into position using a body holdingmechanism. The head position is also confirmed with the patient plan inthe navigation system (block 404), which in one example may beimplemented by the computer or controller forming part of the equipmenttower of medical navigation system 205.

Next, registration of the patient is initiated (block 406). The phrase“registration” or “image registration” refers to the process oftransforming different sets of data into one coordinate system. Data mayinclude multiple photographs, data from different sensors, times,depths, or viewpoints. The process of “registration” is used in thepresent application for medical imaging in which images from differentimaging modalities are co-registered. Registration is used in order tobe able to compare or integrate the data obtained from these differentmodalities.

Those skilled in the relevant arts will appreciate that there arenumerous registration techniques available and one or more of thetechniques may be applied to the present example. Non-limiting examplesinclude intensity-based methods that compare intensity patterns inimages via correlation metrics, while feature-based methods findcorrespondence between image features such as points, lines, andcontours. Image registration methods may also be classified according tothe transformation models they use to relate the target image space tothe reference image space. Another classification can be made betweensingle-modality and multi-modality methods. Single-modality methodstypically register images in the same modality acquired by the samescanner or sensor type, for example, a series of magnetic resonance (MR)images may be co-registered, while multi-modality registration methodsare used to register images acquired by different scanner or sensortypes, for example in magnetic resonance imaging (MRI) and positronemission tomography (PET). In the present disclosure, multi-modalityregistration methods may be used in medical imaging of the head and/orbrain as images of a subject are frequently obtained from differentscanners. Examples include registration of brain computerized tomography(CT)/MRI images or PET/CT images for tumor localization, registration ofcontrast-enhanced CT images against non-contrast-enhanced CT images, andregistration of ultrasound and CT.

Referring now to FIG. 4B, a flow chart is shown illustrating a methodinvolved in registration block 406 as outlined in FIG. 4A, in greaterdetail. If the use of fiducial touch points (440) is contemplated, themethod involves first identifying fiducials on images (block 442), thentouching the touch points with a tracked instrument (block 444). Next,the navigation system computes the registration to reference markers(block 446).

Alternately, registration can also be completed by conducting a surfacescan procedure (block 450). The block 450 is presented to show analternative approach, but may not typically be used when using afiducial pointer. First, the face is scanned using a 3D scanner (block452). Next, the face surface is extracted from MR/CT data (block 454).Finally, surfaces are matched to determine registration data points(block 456).

Upon completion of either the fiducial touch points (440) or surfacescan (450) procedures, the data extracted is computed and used toconfirm registration at block 408, shown in FIG. 4B.

Referring back to FIG. 4A, once registration is confirmed (block 408),the patient is draped (block 410). Typically, draping involves coveringthe patient and surrounding areas with a sterile barrier to create andmaintain a sterile field during the surgical procedure. The purpose ofdraping is to eliminate the passage of microorganisms (e.g., bacteria)between non-sterile and sterile areas. At this point, conventionalnavigation systems require that the non-sterile patient reference isreplaced with a sterile patient reference of identical geometry locationand orientation.

Upon completion of draping (block 410), the patient engagement pointsare confirmed (block 412) and then the craniotomy is prepared andplanned (block 414).

Upon completion of the preparation and planning of the craniotomy (block414), the craniotomy is cut and a bone flap is temporarily removed fromthe skull to access the brain (block 416). Registration data is updatedwith the navigation system at this point (block 422).

Next, the engagement within craniotomy and the motion range areconfirmed (block 418). Next, the procedure advances to cutting the duraat the engagement points and identifying the sulcus (block 420).

Thereafter, the cannulation process is initiated (block 424).Cannulation involves inserting a port into the brain, typically along asulci path as identified at 420, along a trajectory plan. Cannulation istypically an iterative process that involves repeating the steps ofaligning the port on engagement and setting the planned trajectory(block 432) and then cannulating to the target depth (block 434) untilthe complete trajectory plan is executed (block 424).

Once cannulation is complete, the surgeon then performs resection (block426) to remove part of the brain and/or tumor of interest. The surgeonthen decannulates (block 428) by removing the port and any trackinginstruments from the brain. Finally, the surgeon closes the dura andcompletes the craniotomy (block 430). Some aspects of FIG. 4A arespecific to port-based surgery, such as portions of blocks 428, 420, and434, but the appropriate portions of these blocks may be skipped orsuitably modified when performing non-port based surgery.

When performing a surgical procedure using a medical navigation system205, as outlined in connection with FIGS. 4A and 4B, the medicalnavigation system 205 must acquire and maintain a reference of thelocation of the tools in use as well as the patient in three dimensional(3D) space. In other words, during a navigated neurosurgery, there needsto be a tracked reference frame that is fixed relative to the patient'sskull. During the registration phase of a navigated neurosurgery (e.g.,the step 406 shown in FIGS. 4A and 4B), a transformation is calculatedthat maps the frame of reference of preoperative MRI or CT imagery tothe physical space of the surgery, specifically the patient's head. Thismay be accomplished by the navigation system 205 tracking locations offiducial markers fixed to the patient's head, relative to the staticpatient reference frame. The patient reference frame is typicallyrigidly attached to the head fixation device, such as a Mayfield clamp.Registration is typically performed before the sterile field has beenestablished (e.g., the step 410 shown in FIG. 4A).

FIG. 5 is a diagram illustrating components of an exemplary surgicalsystem used in port based surgery that is similar to FIG. 2. FIG. 5illustrates a navigation system 205 having an equipment tower 502,tracking system 504, display 506, an intelligent positioning system 508and tracking markers 510 used to tracked instruments or an access port12. Tracking system 504 may also be considered an optical trackingdevice or tracking camera. In FIG. 5, a surgeon 201 is performing atumor resection through a port 12, using an imaging device 512 (e.g., ascope and camera) to view down the port at a suffcient magnification toenable enhanced visibility of the instruments and tissue. The imagingdevice 512 may be an external scope, videoscope, wide field camera, oran alternate image capturing device. The imaging sensor view is depictedon the visual display 506 which surgeon 201 uses for navigating theport's distal end through the anatomical region of interest.

An intelligent positioning system 508 comprising an automated arm 514, alifting column 516 and an end effector 518, is placed in proximity topatient 202. Lifting column 516 is connected to a frame of intelligentpositioning system 508. As seen in FIG. 5, the proximal end of automatedmechanical arm 514 (further known as automated arm 514 herein) isconnected to lifting column 516. In other embodiments, automated arm 514may be connected to a horizontal beam, which is then either connected tolifting column 516 or directly to frame of the intelligent positioningsystem 508. Automated arm 514 may have multiple joints to enable 5, 6 or7 degrees of freedom.

End effector 518 is attached to the distal end of automated arm 514. Endeffector 518 may accommodate a plurality of instruments or tools thatmay assist surgeon 201 in his procedure. End effector 518 is shown asholding an external scope and camera, however it should be noted thatthis is merely an example and alternate devices may be used with the endeffector 518 such as a wide field camera, microscope and OCT (OpticalCoherence Tomography) or other imaging instruments. In another example,multiple end effectors may be attached to the distal end of automatedarm 518, and thus assist the surgeon 201 in switching between multiplemodalities. For example, the surgeon 201 may want the ability to movebetween microscope, and OCT with stand-off optics. In a further example,the ability to attach a second, more accurate, but smaller range endeffector such as a laser based ablation system with micro-control may becontemplated.

The intelligent positioning system 508 receives as input the spatialposition and pose data of the automated arm 514 and target (for examplethe port 12) as determined by tracking system 504 by detection of thetracking markers on the wide field camera on port 12. Further, it shouldbe noted that the tracking markers may be used to track both theautomated arm 514 as well as the end effector 518 either collectively orindependently. It should be noted that a wide field camera 520 is shownin FIG. 5 and that it is connected to the external scope (e.g., imagingdevice 512) and the two imaging devices together are held by the endeffector 518. It should additionally be noted that although these aredepicted together for illustration of the diagram that either could beutilized independently of the other, for example where an external videoscope can be used independently of the wide field camera 520.

Intelligent positioning system 508 computes the desired joint positionsfor automated arm 514 so as to maneuver the end effector 518 mounted onthe automated arm's distal end to a predetermined spatial position andpose relative to the port 12. This redetermined relative spatialposition and pose is termed the “Zero Position” where the sensor ofimaging device 512 and port 12 are axially alligned.

Further, the intelligent positioning system 508, optical tracking device504, automated arm 514, and tracking markers 510 form a feedback loop.This feedback loop works to keep the distal end of the port 12 (locatedinside the brain) in constant view and focus of the end effector 518given that it is an imaging device as the port position may bedynamically manipulated by the surgeon during the procedure. Intelligentpositioning system 508 may also include a foot pedal for use by thesurgeon 201 to align the end effector 518 (i.e., holding a videoscope)of automated arm 514 with the port 12.

Referring to FIG. 6, a conventional end effector 518 is shown attachedto automated arm 514. The end effector 518 includes a handle 602 and ascope clamp 604. The scope clamp 604 holds imaging device 512. The endeffector also has wide field camera 520 attached thereto.

Referring to FIG. 7, a perspective drawing is shown illustrating anotherexample of an end effector 700. The end effector 700 may connect to apositioning arm, such as the automated arm 514 of a medical navigationsystem 205. The end effector 700 has a mating component 702 forconnecting to an output flange of the positioning arm or for connectingto an end effector joystick controller, discussed below in connectionwith FIGS. 8-15. The end effector 700 further has a handle portion 704having a first end 706 and a second end 708. The first end 706 extendsfrom the mating component 702. The handle portion 704 includes a cablecut-out 710 at the first end 706 for receiving and managing cables. Acamera mount 712 is connected to the second end 708 of the handleportion 704.

The end effector 700 further has a mechanical interface 714 located atthe second end 708 of the handle portion 704. A scope clamp arm 716 maybe connected to the mechanical interface 714. The scope clamp arm 716may have a fastening ring 718 for securing a scope, such as avideoscope. In one example, the mechanical interface 714 may include adovetail interface with the scope clamp arm 716 slideably engagedtherein and secured by a screw 720. In one example, the screw 720 may bea thumbscrew for easily attaching and detaching the scope clamp arm 716.The scope clamp arm 716 may be connectable to a scope for clamping thescope in position adjacent the camera mount 712 using the fastening ring718. The scope may further have an illuminator at a distal end of thescope that is connectable to at least one light pipe.

Referring now to FIG. 8, a perspective drawing is shown illustrating anexemplary end effector joystick controller 800 coupled to an arm of apositioning device. FIG. 9 shows a side view of the end effectorjoystick controller 800 coupled to an arm of a positioning device. FIG.10 shows a perspective view of the end effector joystick controller 800in isolation. FIG. 11 shows an exploded view of the end effectorjoystick controller 800 in isolation. FIG. 12 shows a perspective viewof the end effector joystick controller 800 with a scope and cameraattached. FIG. 13 shows an exploded view of the end effector joystickcontroller 800 with attached scope and camera. FIGS. 8-13 will now bediscussed concurrently.

The end effector joystick controller 800 may connect to and control apositioning arm of a positioning device of a medical navigation system,such as automated arm 514 of medical navigation system 200 (FIG. 5). Theend effector joystick controller 800 generally comprises a matingcomponent 802 for connecting to a flange of the positioning arm and ajoystick portion 804 extending from the mating component.

The joystick portion 804 may include a handle 806 that is attached to ahousing 808, which connects to the mating component 802. In one example,the handle 806 may be in the shape of a puck or a disc. However anysuitable shape may be used for the handle 806, including a shaft, astick, a cylinder, a sphere, a cube, a pyramid, etc. The housing 808 isconnected to the handle 806 and houses a sensor system. In one example,the sensor system may be a six degrees of freedom (6DOF) sensor thatsenses both translation and rotation of the handle 806 with respect tothe mating component 802 in all of the X direction, the Y direction andthe Z direction. In onother example, the sensor system may have a numberof sensors that collectively amount to a 6DOF sensor system that sensesboth translation and rotation of the handle 806 with respect to themating component 802 in all of the X direction, the Y direction and theZ direction. However, the sensor system may be any suitable type ofsensor, such as a 5DOF, 4DOF, or 3DOF sensor.

The end effector joystick controller 800 may further have a secondmating component 810 (FIGS. 12-13) for connecting to an end effector,such as end effectors 518 or 700, or other equipment such as a cameraand scope. In one example, the second mating component 810 includesrigid support members attached to the mating component 802. The rigidsupport members pass through slots or holes 814 formed in the handle806. FIGS. 12 and 13 show three rigid support members for the secondmating component 810 and three corresponding slots or holes 814 formedin the handle 806. However, any suitable number of rigid support membersand corresponding holes 814 may be used according to the design criteriaof a particular application, such as one rigid support member and hole814, two rigid support members and holes 814, four rigid support membersand holes 814, etc. FIGS. 12 and 13 show a scope and/or camera 812attached to end effector joystick controller 800 via second matingcomponent 810.

In one example, the mating component 802 and the joystick portion 804may be axially aligned as shown in FIGS. 8-13, however any othersuitable physical configuration may also be used. In one example, themating component 802 connects to the flange of the positioning arm witha dowel pin and is secured with at least one screw, as shown in FIGS. 8and 9.

Referring now to FIG. 14, another embodiment of an end effector joystickcontroller 900 with a scope and camera attached is shown. FIG. 15 is anexploded view of the end effector joystick controller 900 with attachedscope and camera shown in FIG. 14. FIGS. 14 and 15 will now be discussedconcurrently.

The end effector joystick controller 900 may connect to and control apositioning arm of a positioning device of a medical navigation system,such as automated arm 514 of medical navigation system 200 (FIG. 5). Theend effector joystick controller 900 generally comprises a matingcomponent 902 for connecting to a flange of the positioning arm and ajoystick portion 904 extending from the mating component.

The joystick portion 904 may include a handle 906 that is attached to ahousing 908, which connects to the mating component 902. In theembodiment shown in FIGS. 14-15, mating component 902 includes a shaft903 for elevating the connection point to housing 908. In the embodimentshown in FIGS. 14-15, the joystick portion 904 is off axis with respectto the mating component 902 and the camera and scope 912. Further,handle 906 includes a notch 907 so that the joystick portion 904 may belocated closer to the camera and scope 912.

As with end effector joystick controller 800, the housing 908 isconnected to the handle 906 and houses a sensor, which in one examplemay be a six degrees of freedom (6DOF) sensor system that senses bothtranslation and rotation between the handle 906 and the mating component902 in all of the X direction, the Y direction and the Z direction.However, the sensor may be any suitable type of sensor, such as a 5DOF,4DOF, or 3DOF sensor.

Mating component 902 of end effector joystick controller 900 may connectdirectly to an end effector, such as end effectors 518 or 700, or otherequipment such as a camera and scope 912, as shown in FIGS. 14-15.

The specific embodiments described above have been shown by way ofexample, and it should be understood that these embodiments may besusceptible to various modifications and alternative forms. It should befurther understood that the claims are not intended to be limited to theparticular forms disclosed, but rather to cover all modifications,equivalents, and alternatives falling within the spirit and scope ofthis disclosure.

1. An end effector controller for connecting to and controlling apositioning arm of a positioning device, the end effector controllercomprising: a mating component for connecting to a flange of thepositioning arm; and a handle portion extending from the matingcomponent, the handle portion comprising: a puck-shaped handle; ahousing portion attached to the handle and the mating component; and a 6degrees of freedom (6DOF) sensor system housed in the housing portionand connected to the handle, the sensor system being configured to senseboth translation and rotation in all of the X direction, the Y directionand the Z direction.
 2. The end effector controller according to claim1, further comprising: a second mating component attached to the firstmating component, the second mating component for connecting to an endeffector.
 3. The end effector controller according to claim 2, whereinthe second mating component includes a rigid support member.
 4. The endeffector controller according to claim 3, wherein the rigid supportmember passes through holes formed in the handle.
 5. The end effectorcontroller according to claim 4, wherein a plurality of rigid supportmembers each passes through a corresponding hole in the handle.
 6. Theend effector controller according to claim 1, wherein the matingcomponent and the handle portion are axially aligned.
 7. The endeffector controller according to claim 1, wherein the mating componentconnects to the flange of the positioning arm with a dowel pin and issecured with at least one screw.
 8. A medical navigation system,comprising: a positioning device having a positioning arm with a flangeat the end of the positioning arm; a controller at least electricallycoupled to the positioning device, the controller having a processorcoupled to a memory and a display; and an end effector controller forconnecting to the flange of the positioning arm, the end effectorcontroller comprising: a mating component for connecting to the flangeof the positioning arm; and a handle portion extending from the matingcomponent, the handle portion comprising: a puck-shaped handle; ahousing portion attached to the handle and the mating component; and a 6degrees of freedom (6DOF) sensor system housed in the housing portionand connected to the handle, the sensor system being configured to senseboth translation and rotation in all of the X direction, the Y directionand the Z direction.
 9. The medical navigation system according to claim8, the end effector controller further comprising: a second matingcomponent attached to the first mating component, the second matingcomponent for connecting to an end effector.
 10. The medical navigationsystem according to claim 9, wherein the second mating componentincludes a rigid support member.
 11. The medical navigation systemaccording to claim 10, wherein the rigid support member passes through ahole formed in a handle.
 12. The medical navigation system according toclaim 11, wherein there is a plurality of rigid support members eachpassing through a corresponding hole in the handle.
 13. The medicalnavigation system according to claim 8, wherein the mating component andthe handle portion are axially aligned.
 14. The medical navigationsystem according to claim 8, wherein the mating component connects tothe flange of the positioning arm with a dowel pin and is secured withat least one screw.